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Ladies First

Equality of the sexes in the boardroom? It’s about time. The kitchen and the classroom? Absolutely. The doctor’s office? Now there’s a novel idea....

Men and women experience health in fundamentally different ways. Did you know that a woman on the verge of a heart attack might experience palpitations, jaw pain or fatigue but not the classic symptom of crushing chest pain? Or that standard doses of medication are usually based on the body of a 160-pound man?

Medical science is giving us new insights all the time into the very nuanced things that happen between a woman’s hair and her toes. Experts say the conclusion is clear — women need gender-specific services and treatment.

The best way to get them is by seeking out a primary care physician who has an interest in women’s healthcare. That’s easy to ascertain — just ask. While you’re at it, find out if the doctor is board certified. (If not, it might not be a deal breaker, just something to consider.) Ask about practical matters. Can I get a refill over the weekend? How long does it take to get a phone call returned? Does the doc do e-mail?

Perhaps most important of all, you’ll want a doctor with whom you can share the most intimate details of your life. A woman should feel “that there are no subjects that are off limits,” said Juanita Watts, a physician and regional women’s health coordinator for the Southern California Permanente Medical Group.

“The other big thing is to look for a physician who shares authority — who doesn’t just say, ‘Here, you will take this,’” said Dr. Sharon Orrange, an internal medicine specialist and assistant professor at the Keck School of Medicine at USC.

Finding a doctor
But where do you find a doctor in the first place? Start by asking female friends and relatives for recommendations, said Dr. Camelia Davtyan, a physician with the Iris Cantor-UCLA Women’s Health Center. What about those online ratings? Keep in mind that they will probably be skewed negatively. It’s generally the grumblers who take the time to complain.

Once you get a name, there’s nothing wrong with interviewing a doctor before you make your selection, Watts added. But first, do a little medical self-assessment and make note of your healthcare needs and concerns, she said. That will help you focus on what exactly you’re looking for in a physician.

If the two of you don’t mesh, move on. “I meet patients all the time who will say to me, ‘I went 10 years before I met a physician I could really talk to.’ Well, why did you go 10 years? You have so much choice!” Orrange said.

Specialist or generalist?
But what kind of primary care physician do you need?

An obstetrician-gynecologist may be fine for primary care for a healthy woman in her 20s. But along with age come chronic conditions such as hypertension and diabetes. That’s why it’s a good idea for women, as they age, to seek out an internal medicine doctor (which simply means that he or she specializes in adult medicine), Davtyan said. In most cases, this physician can do your pap smears and breast exams.
In fact, you may not even need an ob-gyn for routine matters. “I’m an internal medicine doctor and patients are always surprised when I say I can do their pap,” Orrange said.

Prevention
So, you and your new doctor are simpatico. What next?

The medical community has known for a long time that it’s easier to prevent disease and injury than to treat and cure them. That’s why there’s such a big push on preventive care.

It starts early in a woman’s life, and even in the teen and preteen years in the case of the human papillomavirus, or HPV, vaccine — which guards against most cervical cancers — or chlamydia screening for those who are sexually active.

There are many more tests, screenings and vaccines. Some — like annual pap smears starting at age 21, mammograms at 40, and post-menopausal bone-density scanning — are specific to women.

Others — a cholesterol check at 18 and colonoscopy at 50 — are not. Vaccines for the flu (recommended annually for everyone except small babies), shingles at age 60 and pneumonia at age 65 are for both sexes, but nonetheless important to keep in mind.  

You may not be able to remember everything you’re supposed to have and when, but your doctor will. Just ask: “What age-appropriate screening do I need?” Your doctor will also remind you about other aspects of routine healthcare, like taking a calcium supplement with vitamin D at menopause.

The things you should absolutely have memorized are your “numbers” — blood pressure, cholesterol, body mass index and one or two others. “Know if they are normal or not and if there’s something you have to keep your eye on,” Orrange said.

America may still be wrestling with healthcare reform, Watts noted, “but reform starts at home. It starts with our own health and our bodies and our lives.”

—Anne Burke, Brand Publishing Writer

 


 

 

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